Question 1

Which client has the priority need for fetal monitoring?

Accepted Answer

A)  Primigravida at 38 weeks with spontaneous ROM 
B)  Multigravida at 40 weeks with history of 10-hour labors 
C)  Multigravida admitted for repeat elective cesarean section 
D)  Primigravida at 39 weeks with meconium-stained amniotic fluid

Question 2

Client is at 38 weeks' gestation, gravida 1, para 0, vaginal exam-4 cm, 100% effaced, +1 station vertex. What is the most likely intervention for this fetal heart rate pattern?

Accepted Answer

A)  Continue oxytocin (Pitocin) infusion. 
B)  Contact the anesthesia department for epidural administration. 
C)  Change maternal position. 
D)  Administer Narcan to client and prepare for immediate vaginal delivery.

Question 3

Match each term with the correct definition.
-Late decelerations

Accepted Answer

A) Caused by umbilical cord compression 
B) Caused by fetal head compression 
C) Caused by uteroplacental insufficiency

Question 4

What is the most likely cause for this fetal heart rate pattern?

Accepted Answer

A)  Administration of an epidural for pain relief during labor 
B)  Cord compression 
C)  Breech position of fetus 
D)  Administration of meperidine (Demerol) for pain relief during labor

Question 5

Match each term with the correct definition.
-Early decelerations

Accepted Answer

A) Caused by umbilical cord compression 
B) Caused by fetal head compression 
C) Caused by uteroplacental insufficiency

Question 6

Which is the most appropriate method of intrapartum fetal monitoring when a woman has a history of hypertension during pregnancy?

Accepted Answer

A)  Continuous auscultation with a fetoscope 
B)  Continuous electronic fetal monitoring 
C)  Intermittent assessment with a Doppler transducer 
D)  Intermittent electronic fetal monitoring for 15 minutes each hour

Question 7

Which of the following therapeutic applications provides the most accurate information related to uterine contraction strength?

Accepted Answer

A)  External fetal monitoring (EFM) 
B)  Internal fetal monitoring 
C)  Intrauterine pressure catheter (IUP
C)  
D)  Maternal comments based on perception

Question 8

The nurse recognizes that fetal scalp stimulation may be prescribed to evaluate the response of the fetus to tactile stimulation. Which conditions contraindicate the use of fetal scalp stimulation? (Select all that apply.)

Accepted Answer

A)  Post-term fetus 
B)  Maternal fever 
C)  Placenta previa 
D)  Induction of labor 
E)  Prolonged rupture of membranes

Question 9

In which situation would it be appropriate to obtain a fetal scalp blood sample to establish fetal well-being?

Accepted Answer

A)  The fetus has developed tachycardia related to maternal fever. 
B)  The mother has vaginal bleeding, and the baseline fetal heart rate is decreasing. 
C)  The fetal heart tracing on a preterm fetus shows decreased baseline variability. 
D)  The fetal heart tracing shows a persistent pattern of late decelerations, with normal baseline variability.

Question 10

To clarify the fetal condition when baseline variability is absent, the nurse should first:

Accepted Answer

A)  monitor fetal oxygen saturation using fetal pulse oximetry. 
B)  notify the physician so that a fetal scalp blood sample can be obtained. 
C)  apply pressure to the fetal scalp with a glove finger using a circular motion. 
D)  increase the rate of nonadditive IV fluid to expand the mother's blood volume.

Question 11

Increasing the infusion rate of nonadditive intravenous fluids can increase fetal oxygenation primarily by:

Accepted Answer

A)  expanding the maternal blood volume. 
B)  maintaining a normal maternal temperature. 
C)  preventing normal maternal hypoglycemia. 
D)  increasing the oxygen-carrying capacity of the maternal blood.

Question 12

A nurse documents that the fetal heart rate variability is marked. This indicates that the range is greater than how many beats per minute? Record your answer as a whole number.
_____ bpm

Accepted Answer

The answer of A nurse documents that the fetal heart...

Question 13

Proper placement of the tocotransducer for electronic fetal monitoring is:

Accepted Answer

A)  inside the uterus. 
B)  on the fetal scalp. 
C)  over the uterine fundus. 
D)  over the mother's lower abdomen.

Question 14

Why is continuous electronic fetal monitoring generally used when oxytocin is administered?

Accepted Answer

A)  Fetal chemoreceptors are stimulated. 
B)  The mother may become hypotensive. 
C)  Maternal fluid volume deficit may occur. 
D)  Uteroplacental exchange may be compromised.

Question 15

Which can be determined only by electronic fetal monitoring?

Accepted Answer

A)  Variability 
B)  Tachycardia 
C)  Bradycardia 
D)  Fetal response to contractions

Question 16

Which maternal condition should be considered a contraindication for the application of internal monitoring devices?

Accepted Answer

A)  Unruptured membranes 
B)  Cervix dilated to 4 cm 
C)  Fetus has known heart defect 
D)  External monitors currently being used

Question 17

The nurse is reviewing an electronic fetal monitor tracing from a patient in active labor and notes the fetal heart rate gradually drops to 20 beats per minute (bpm) below the baseline and returns to the baseline well after the completion of the patient's contractions. How will the nurse document these findings?

Accepted Answer

A)  Late decelerations 
B)  Early decelerations 
C)  Variable decelerations 
D)  Proximal decelerations

Question 18

In which situation would a baseline fetal heart rate of 160 to 170 bpm be considered a normal finding?

Accepted Answer

A)  The fetus is at 30 weeks of gestation. 
B)  The mother has a history of fast labors. 
C)  The mother has been given an epidural block. 
D)  The mother has mild preeclampsia but is not in labor.

Question 19

When the deceleration pattern of the fetal heart rate mirrors the uterine contraction, which nursing action is indicated?

Accepted Answer

A)  Reposition the client. 
B)  Apply a fetal scalp electrode. 
C)  Record this reassuring pattern. 
D)  Administer oxygen by nasal cannula.

Question 20

Which nursing action is correct when initiating electronic fetal monitoring?

Accepted Answer

A)  Lubricate the tocotransducer with an ultrasound gel. 
B)  Securely apply the tocotransducer with a strap or belt. 
C)  Inform the client that she should remain in the semi-Fowler position. 
D)  Determine the position of the fetus before attaching the electrode to the maternal abdomen.

Exam 14: Intrapartum Fetal Surveillance